Revista de Odontologia da UNESP
https://www.revodontolunesp.com.br/article/doi/10.1590/1807-2577.03721
Revista de Odontologia da UNESP
Original Article

Endo-perio lesions prevalence in non-molar and molar teeth: a pilot study

Prevalência de lesões endo-perio em dentes não-molares e molares: um estudo piloto

Flávia Cristina Castilho CUCOLO; Mariana Costa BONVALENTE; Eliane Marçon BARROSO; Benedicto Egbert Corrêa de TOLEDO; Gabriela Alessandra da Cruz Galhardo CAMARGO; Alessandra Areas e SOUZA; Elizangela Cruvinel ZUZA

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Abstract

Abstract: Introduction: Pulp and periodontal tissues may communicate and, in pathological situations, combined endodontic-periodontal lesions may be established.

Objective: The aim of this study was to evaluate the prevalence of endo-perio lesions in non-molar and molar teeth referred for endodontic treatment.

Material and method: The sample consisted of 104 teeth evaluated in 79 consecutive patients in a cross-sectional design. Visible plaque, probing depth, and bleeding on probing were evaluated. Endodontic evaluation included the presence or absence of caries, fistulas, pain, and pulp sensitivity. The presence/absence of periapical lesion, bone loss in the furcation region, and proximal area were evaluated.

Result: The results showed that pain was the main reason for seeking dental care in 63.3% of patients. The molar teeth demonstrated higher presence of probing depth (PD) ≥ 7 mm (38.3%) and higher PD mean (6.17 mm) than non-molar teeth (P<0.05). It was verified that 65.4% of the teeth were diagnosed with a primary endodontic lesion and that the periodontal component was present in 34.6% of the teeth, either in a primary (10.6%), secondary (11.5%), or combined form (12.5%). True combined endodontic-periodontal lesion occurred significantly in molar teeth compared to non-molar teeth (p<0.05).

Conclusion: The primary endodontic lesion was found in a greater proportion in teeth referred for endodontic treatment; however, approximately 1/3 of the sample had periodontal involvement, which demonstrates the importance of the periodontal examination together with the general clinical examination.

Keywords

Dental pulp diseases, diagnosis, endodontics, periodontics, cross-sectional studies, periodontal diseases

Resumo

Resumo: Introdução: Os tecidos pulpar e periodontal podem se comunicar e, em situações patológicas, podem-se estabelecer lesões endodônticas-periodontais combinadas.

Objetivo: O objetivo deste estudo foi avaliar a prevalência de lesões endo-perio em dentes não molares e molares encaminhados para tratamento endodôntico.

Material e método: A amostra consistiu de 104 dentes avaliados em 79 pacientes consecutivos em um desenho transversal. Placa visível, profundidade de sondagem e sangramento à sondagem foram avaliados. A avaliação endodôntica incluiu a presença ou ausência de cáries, fístulas, dor e sensibilidade pulpar. Foram avaliados a presença / ausência de lesão periapical, perda óssea em região de furca e área proximal.

Resultado: Os resultados mostraram que a dor foi o principal motivo de procura de atendimento odontológico em 63,3% dos pacientes. Os dentes molares demonstraram maior presença de profundidade de sondagem (PS) ≥ 7 mm (38,3%) e maior média de PS (6,17 mm) do que os dentes não molares (P <0,05). Verificou-se que 65,4% dos dentes tinham diagnóstico de lesão endodôntica primária e que o componente periodontal estava presente em 34,6% dos dentes, seja na forma primária (10,6%), secundária (11,5%) ou combinada (12,5%). Lesão endodôntica-periodontal combinada verdadeira ocorreu significativamente em dentes molares em comparação com os dentes não molares (p <0,05).

Conclusão: A lesão endodôntica primária foi encontrada em maior proporção nos dentes encaminhados para tratamento endodôntico; entretanto, aproximadamente 1/3 da amostra apresentava acometimento periodontal, o que demonstra a importância do exame periodontal em conjunto com o exame clínico geral.
 

Palavras-chave

Doenças da polpa dentária, diagnóstico, endodontia, periodontia, estudos transversais, doenças periodontais

References

1 Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018 Jun;89(Suppl. 1):S173-82. http://dx.doi.org/10.1002/JPER.17-0721. PMid:29926951.

2 Simon JH, Glick DH, Frank AL. The relationship of endodontic-periodontic lesions. J Periodontol. 1972 Apr;43(4):202-8. http://dx.doi.org/10.1902/jop.1972.43.4.202. PMid:4505605.

3 Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999 Dec;4(1):1-6. http://dx.doi.org/10.1902/annals.1999.4.1.1. PMid:10863370.

4 Simon JHS, Glick DH, Frank AL. The relationship of endodontic-periodontic lesions. J Endod. 2013 May;39(5):e41-6. http://dx.doi.org/10.1016/j.joen.2013.02.006. PMid:23611400.

5 Al-Fouzan KS. A new classification of endodontic-periodontal lesions. Int J Dent. 2014;2014:919173. http://dx.doi.org/10.1155/2014/919173. PMid:24829580.

6 Hirsch RS, Clarke NG. Pulpal disease and bursts of periodontal attachment loss. Int Endod J. 1993 Nov;26(6):362-8. http://dx.doi.org/10.1111/j.1365-2591.1993.tb00770.x. PMid:8144246.

7 Meng HX. Periodontic-endodontic lesions. Ann Periodontol. 1999 Dec;4(1):84-90. http://dx.doi.org/10.1902/annals.1999.4.1.84. PMid:10863379.

8 Neves VCQ, Toledo BEC, Camargo GACG, Souza AA, Zuza EP. Determination of the influence of chronic periodontitis on pulp sensibility by means of electric and thermal cold testing. J Endod. 2017 Nov;43(11):1802-5. http://dx.doi.org/10.1016/j.joen.2017.07.006. PMid:28951030.

9 Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol. 1988 Aug;59(8):493-503. http://dx.doi.org/10.1902/jop.1988.59.8.493. PMid:3171862.

10 Rubach WC, Mitchell DF. Periodontal disease, accessory canals and pulp pathosis. J Periodontol. 1965 Jan-Feb;36(1):34-8. http://dx.doi.org/10.1902/jop.1965.36.1.34. PMid:14258503.

11 Zuza EP, Toledo BEC, Hetem S, Spolidorio LC, Mendes AJD, Rosetti EP. Prevalence of different types of accessory canals in the furcation area of third molars. J Periodontol. 2006 Oct;77(10):1755-61. http://dx.doi.org/10.1902/jop.2006.060112. PMid:17032120.

12 Matthews DC, Tabesh M. Detection of localized tooth-related factors that predispose to periodontal infections. Periodontol 2000. 2004;34(1):136-50. http://dx.doi.org/10.1046/j.0906-6713.2003.003429.x. PMid:14717860.

13 Angst PDM, Piccinin FB, Oppermann RV, Marcantonio RAC, Gomes SC. Response of molars and non-molars to a strict supragingival control in periodontal patients. Braz Oral Res. 2013 Jan-Feb;27(1):55-60. http://dx.doi.org/10.1590/S1806-83242013000100010. PMid:23306627.

14 Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975 Dec;25(4):229-35. PMid:1058834.

15 Armitage GC. The complete periodontal examination. Periodontol 2000. 2004;34(1):22-33. http://dx.doi.org/10.1046/j.0906-6713.2002.003422.x. PMid:14717853.

16 Gjermo P, Bellini HT, Santos VP, Martins IG, Ferracyoli JR. Prevalence of bone loss in a group of Brazilian teenagers assessed on bite‐wing radiographs. J Clin Periodontol. 1984 Feb;11(2):104-13. http://dx.doi.org/10.1111/j.1600-051X.1984.tb00838.x. PMid:6583209.

17 Aass AM, Rossow I, Preus HR, Gjermo P. Incidence of early periodontitis in a group of young individuals during 8 years: associations with selected potential predictors. J Periodontol. 1994 Sep;65(9):814-9. http://dx.doi.org/10.1902/jop.1994.65.9.814. PMid:7990016.

18 Rotstein I, Simon JHS. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000. 2004;34(1):165-203. http://dx.doi.org/10.1046/j.0906-6713.2003.003431.x. PMid:14717862.

19 Jansson LE, Ehnevid H. The influence of endodontic infection on periodontal status in mandibular molars. J Periodontol. 1998 Dec;69(12):1392-6. http://dx.doi.org/10.1902/jop.1998.69.12.1392. PMid:9926769.

20 Zuza EP, Carrareto ALV, Lia RCC, Pires JR, Toledo BEC. histopathological features of dental pulp in teeth with different levels of chronic periodontitis severity. ISRN Dent. 2012;2012:271350. http://dx.doi.org/10.5402/2012/271350. PMid:22577568.

21 Langeland K, Rodrigues H, Dowden W. Periodontal disease, bacteria, and pulpal histopathology. Oral Surg Oral Med Oral Pathol. 1974 Feb;37(2):257-70. http://dx.doi.org/10.1016/0030-4220(74)90421-6. PMid:4520855.

22 Janssen LE, Ehnevid H, Lindskog SF, Blomlöf LB. Radiographic attachment in periodontitis-prone teeth with endodontic infection. J Periodontol. 1993 Oct;64(10):947-53. http://dx.doi.org/10.1902/jop.1993.64.10.947. PMid:8277402.

23 Li H, Guan R, Sun J, Hou B. Bacteria community study of combined periodontal-endodontic lesions using denaturing gradient gel electrophoresis and sequencing analysis. J Periodontol. 2014 Oct;85(10):1442-9. http://dx.doi.org/10.1902/jop.2014.130572. PMid:24579762.

24 Jansson L, Ehnevid H, Lindskog S, Blomlöf L. The influence of endodontic infection on progression of marginal bone loss in periodontitis. J Clin Periodontol. 1995 Oct;22(10):729-34. http://dx.doi.org/10.1111/j.1600-051X.1995.tb00254.x. PMid:8682918.

25 Miyashita H, Bergenholtz G, Gröndohl K, Wennström JL. Impact of endodontic conditions on marginal bone loss. J Periodontol. 1998 Feb;69(2):158-64. http://dx.doi.org/10.1902/jop.1998.69.2.158. PMid:9526914.
 


Submitted date:
07/21/2021

Accepted date:
09/01/2021

6172cf10a9539536ba799932 rou Articles
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